title: Downbeat nystagmus, ataxia and spastic tetraparesis due to coeliac disease.
abstract: A 25-year-old female presented to a university neurology clinic with a 1-month history of progressive ataxia, downbeat nystagmus and spastic tetraparesis. Personal history revealed polyarthralgias and weight loss. Family history was negative. Following thorough history, laboratory, neurophysiological and MRI investigations, a diagnosis of cerebellar ataxia due to coeliac disease was done. The patient was treated with strict gluten-free diet and intravenous administration of immunoglobulins. Although there are many controversies about neurological manifestations of coeliac disease, this case pointed to strong association between these two disorders. The findings of elevated protein content in the cerebrospinal fluid with positive oligoclonal bands suggested an immune-mediated process, further supported by positive anti-endomysium antibodies and anti-transglutaminase antibodies in the cerebrospinal fluid.
authors.affiliation: Department of Neurology, School of Medicine, University of Zagreb, Zagreb, Croatia. mhabek@mef.hr
authors.forename: Mario
authors.initials: M
authors.lastname: Habek
authors.forename: Iva
authors.initials: I
authors.lastname: Hojsak
authors.forename: Barbara
authors.initials: B
authors.lastname: Barun
authors.forename: Vesna V
authors.initials: VV
authors.lastname: Brinar
mesh_terms: D000328:Adult; D001259:Ataxia / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000276:immunology; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000276:immunology; D011782:Quadriplegia / Q000209:etiology* / Q000276:immunology; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D011503:Transglutaminases